RESUMO
BACKGROUND: The surgical management of cholesteatoma is a controversial issue, particularly regarding intact-canal-wall mastoidectomy (ICWM) versus canal-wall-down mastoidectomy (CWDM). The current experiment compared the quality of visualization in different middle ear structures using ICWM with otoendoscopy with findings of CWDM by microscopy. MATERIALS AND METHODS: The patients diagnosed with cholesteatoma underwent tympanomastoidectomy, and then the patients selected for CWDM were included in the study (25 patients: 11 females and 14 males). After removing the cholesteatoma from the involved areas, otoendoscopic examination was done with a 4 mm, 0° endoscope by a neurootologist. All five middle ear structures (lateral epitympanum, sinus tympani, posterior crus of the stapes, round window niche, and Eustachian tube orifice) suspected of occult cholesteatoma were evaluated in terms of having or lacking the pathology. Then, CWDM was performed and all of the mentioned sites were reevaluated for diagnosing occult cholesteatoma. RESULTS: The symmetric measures were 73%, 92%, 63%, 81%, and 100% for lateral epitympanum, sinus tympani, posterior crus of the stapes, round window niche, and Eustachian tube orifice, respectively. CONCLUSION: Otoendoscopy was confirmed to have a great potential to be adopted by surgeons as a less invasive procedure in the surgical management of middle ear cholesteatoma.
RESUMO
INTRODUCTION: Lipomas of the larynx are very rare benign lesions; macroscopically, they resemble retention cysts, so their diagnosis is usually made after surgery. CASE REPORT: A rare case of pediatric paraglottic space Lipoma in an 11-year-old boy is explained. The mass was mobile, soft, without fluctuation or pulsation. CT scan revealed a 5.7 cm cervical fat density with regional lymphadenopathy. After lateral neck incision, a mass located deep in the carotid artery, which was attached to the larynx and which extended to the paraglottic space, was excised completely. Pathologic evaluation revealed Lipoma without any evidence of malignant cells present. CONCLUSION: This rare differential diagnosis for neck masses in pediatric population should be considered.
